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General NPI Number Information
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NPI Number | 1154324929
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Entity Type | Organization
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Legal Business Name | OKANOGAN BEHAVIORAL HEALTHCARE
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 1007 KOALA DR
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City | OMAK
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State | WA
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Zip | 98841-9247
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Country | US
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Telephone | 509-826-6191
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Fax | 509-826-3029
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Provider Business Mailing Address
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Address Line | 1007 KOALA DR
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City | OMAK
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State | WA
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Zip | 98841-9247
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Country | US
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Telephone | 509-826-6191
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Fax | 509-826-3029
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Authorized Official
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Title or Position | CEO
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Name | MR. DAVID MCCLAY
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Credential |
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Telephone | 509-826-6191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 602 200 591
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License Number State | WA
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